Provider Demographics
NPI:1003143074
Name:LOUIS J. KORPICS JR., D.D.S.
Entity Type:Organization
Organization Name:LOUIS J. KORPICS JR., D.D.S.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:KORPICS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:804-798-2776
Mailing Address - Street 1:130 THOMPSON ST
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-1526
Mailing Address - Country:US
Mailing Address - Phone:804-798-2776
Mailing Address - Fax:804-798-3110
Practice Address - Street 1:130 THOMPSON ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-1526
Practice Address - Country:US
Practice Address - Phone:804-798-2776
Practice Address - Fax:804-798-3110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-11
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010076531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty